title: Gene expression profiling for cardiac rejection surveillance is not predictive of post-transplantation skin cancer.
abstract: BACKGROUND
  The risk of skin cancer in solid organ transplant recipients (SOTR) is 50 to 100 times as great as in those without a transplant. Multiple factors, including immunosuppression, influence the development of post-transplantation skin cancer. Individuals with cardiac transplant are serially screened for organ rejection and immunosuppressive regimen effectiveness. Gene expression profiling of peripheral blood mononuclear cells has been established as a noninvasive test for monitoring cardiac rejection.
  
  
  OBJECTIVE
  We examined individuals with cardiac transplant monitored using peripheral gene expression profiling to determine whether the profile of peripheral blood mononuclear cell activity could correlate with the development of post-transplantation skin cancer.
  
  
  METHODS
  Sixty-one patient records were examined for initial endomyocardial biopsy results, gene expression profiling data, immunosuppressive regimens, and post-transplantation skin cancer.
  
  
  RESULTS
  There was no relationship between acute rejection and the development of skin cancer. No relationship between peripheral gene expression profiling and the development of post-transplantation skin cancer was observed. The most common skin cancer in the population was squamous cell carcinoma. SOTR suppressed with azathioprine had a significantly higher incidence of squamous cell carcinoma.
  
  
  CONCLUSIONS
  Although gene expression tests have advanced transplant surveillance, they were not associated with post-transplantation skin cancer.
authors.affiliation: Yale Dermatologic Surgery, Yale University, New Haven, Connecticut.
authors.forename: Allison
authors.initials: A
authors.lastname: Hanlon
authors.forename: Megan
authors.initials: M
authors.lastname: O'Neill
authors.forename: Fiona
authors.initials: F
authors.lastname: Fang
authors.forename: Heidi
authors.initials: H
authors.lastname: Chen
authors.forename: Jason
authors.initials: J
authors.lastname: Lott
authors.forename: Mark
authors.initials: M
authors.lastname: Wigger
authors.forename: Thomas
authors.initials: T
authors.lastname: Stasko
mesh_terms: D000328:Adult; D000368:Aged; D001379:Azathioprine / Q000009:adverse effects; D002294:Carcinoma, Squamous Cell / Q000235:genetics* / Q000276:immunology; D015870:Gene Expression; D020869:Gene Expression Profiling; D006084:Graft Rejection / Q000235:genetics* / Q000473:pathology; D016027:Heart Transplantation / Q000009:adverse effects; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects; D007166:Immunosuppressive Agents / Q000009:adverse effects; D007963:Leukocytes, Mononuclear; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000235:genetics* / Q000276:immunology
chemical_list: D007166:Immunosuppressive Agents; D001379:Azathioprine